Provider Demographics
NPI:1477185478
Name:SCHOHL, ANDREW TYLER
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:TYLER
Last Name:SCHOHL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W10085 PIKE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WI
Mailing Address - Zip Code:54119-9285
Mailing Address - Country:US
Mailing Address - Phone:616-264-4031
Mailing Address - Fax:
Practice Address - Street 1:715 PYLE DR
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802-4456
Practice Address - Country:US
Practice Address - Phone:906-774-0522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI6851110810104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician